| Doxycycline Improves Filarial Lymphedema Independent of Active Filarial Infection: A Randomized Controlled Trial. | |
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MedLine Citation:
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PMID: 22610930 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BackgroundThe aim of this study was to determine whether improvement of filarial lymphedema (LE) by doxycycline is restricted to patients with ongoing infection (positive for circulating filarial antigen (CFA+)), or whether the majority of CFA- LE patients would also show a reduction in LE severity.Methods162 Ghanaian participants with LE stage 1-5 (Dreyer) were randomized blockwise into 2 groups (CFA+, CFA-) and allocated to 3 treatment arms of 6 weeks: 1) amoxicillin 1000 mg/d, 2) doxycycline 200 mg/d, or 3) placebo matching doxycycline. All groups received standard hygiene morbidity management. Primary outcome was reduction of LE stages. Secondary outcomes comprised frequency of acute attacks and ultrasonographical assessment of skin thickness at the ankles. Parameters were assessed pre-treatment and after 3, 12 and 24 months.ResultsDoxycycline-treated patients with stages 2-3 showed significant reductions in LE severity after 12 and 24 months, regardless of CFA status. Improvement was observed in 43.9% of doxycycline treated patients whereas only 3.2% and 5.6% showed improvement in the amoxicillin and placebo arms respectively. Skin thickness correlated with LE stage improvement. Both doxycycline and amoxicillin were able to reduce ADLA attacks.ConclusionsDoxycycline treatment improves mild to moderate LE independent of ongoing infection. This finding expands the benefits of doxycycline to the entire population of patients suffering from LE. Patients with LE stage 1 to 3 should benefit from a 6-week course of doxycycline every other year or yearly, which should be considered as an improved tool for morbidity management of filarial LE. |
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Authors:
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Sabine Mand; Alexander Yaw Debrah; Ute Klarmann; Linda Batsa; Yeboah Marfo-Debrekyei; Alexander Kwarteng; Sabine Specht; Aurea Belda-Domene; Rolf Fimmers; Mark Taylor; Ohene Adjei; Achim Hoerauf |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-5-18 |
Journal Detail:
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Title: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America Volume: - ISSN: 1537-6591 ISO Abbreviation: - Publication Date: 2012 May |
Date Detail:
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Created Date: 2012-5-21 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9203213 Medline TA: Clin Infect Dis Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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